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How to Get an ADHD Diagnosis in the UK
Patients with ADHD often face a network of gatekeepers when seeking referrals or assessment and support. It is clear that many of these gatekeepers, notably in NHS CCGs, do not follow national clinical guidelines and their legal obligations to stop health inequalities and discrimination.
Anecdotal evidence suggests that some private ADHD clinics are not sufficiently controlled. This could result in inconsistent diagnostic thresholds and assessment reporting that could cause problems when trying to transfer back to the NHS.
How do I get a medical diagnosis?
ADHD is a mental health issue that means it must be diagnosed by a healthcare professional with specialist knowledge. This includes psychiatrists and psychology (who are the only professionals certified to diagnose ADHD in the UK). People with mental health conditions often report symptoms of ADHD, especially those who have struggled for a long period. They may feel trapped in their current situation, and desperate for assistance. The NHS can be difficult for those trying to find an answer to a medical condition.
It is possible to get a diagnosis through the NHS by asking your GP for a referral to see an expert. Your GP will be attentive to your concerns and should be able to send you to a specialist for an examination but you may have to wait until the specialist is available.
When assessing for ADHD healthcare experts will examine the family history of ADHD and any other mental health issues that you have experienced in the past. To determine your behavior, they'll observe you in various settings, such as at home, school, or work. They will ask you to describe your symptoms and how they affect your daily life. They may also ask about your relationships, social life and any other activities that you take part in on a regular basis.
A specialist will examine all the evidence before making an assessment. They will look at criteria such as being restless and fidgety at all times or having short-term memory issues and having trouble staying focused or keeping up at school or at work, failing to complete tasks, and being extremely energetic. The diagnosis will be based on the presence of these traits in a variety of settings, which affects your performance and if there's a distinct pattern that has remained for at least six years.
In recent months, there has been a rise in the number of celebrities talking about their experiences of being diagnosed with ADHD. This has led to an increase in people seeking an assessment. This can lead to long waiting for healthcare professionals. Some patients and their families avoid the NHS in order to have their medical examinations at private clinics. This could be costly. It is essential to choose the right healthcare provider who you can trust and to be honest about the symptoms you are experiencing.
What happens during the assessment process?
Whether you're self-referring or getting referred by your GP, the process of assessing ADHD symptoms is very similar. The person conducting the assessment will ask you questions about how your symptoms impact your daily life, like "What difficulties do you encounter at home?", "How do your symptoms affect your work?", and "Do you have any other symptoms you believe might be related to ADHD?"
You may be required to fill out a variety of forms or questionnaires before your appointment, based on the location you're going to for your assessment. Making sure you complete these forms in a timely manner will help to avoid any delays to your appointment. It's also important to become familiar with the signs (symptoms) of ADHD to be able to recognise them and discuss how they impact your life in detail.
The test will usually involve an interview with a psychiatrist, specialist nurse or other appropriately qualified healthcare professional. The therapist will assess both your mental health and ADHD symptoms to determine if they are caused by a different condition or not (NICE guidelines). The clinician will then discuss the treatment options with you, which could include medication.
It is important to keep in mind that GPs, nurses and psychologists will not be as well-versed in adult ADHD as specialist Psychiatrists It is therefore essential to prepare and practice your symptoms before you go for an assessment. This will enable you to communicate the impact that your symptoms are having in a manner that they can understand. You'll need to provide examples on how your symptoms have affected your life in all aspects, from your work to your relationships, and over time.
You may have tests done in the course of your examination, such as an examination of your blood to look for any allergies. Your therapist might suggest additional tests to check whether you have any other medical problems.
If you self-refer, or enrolled in the Right to Choose scheme, it is important to remember that although you pay for your private examination however, you must wait for NHS funded appointments - and this can vary between NHS trusts and from one physician to another.
What is the outcome if I don't receive a diagnosis?
There are a variety of factors that could prevent you from being diagnosed with ADHD. It is more difficult for some groups of people to be diagnosed, for example, when you are of color or assigned a female at birth or if you have other mental health diagnoses like depression or bipolar disorder.
If you're having difficulty getting an answer, you can talk to your GP about it and asking for the referral to a psychiatrist. You could also locate a private psychiatrist who is specialized in adult ADHD assessments. They can provide a more rapid service than the NHS.
The psychiatrist will evaluate your symptoms to determine if they fit the Nice guidelines for ADHD. They will also attempt to eliminate other causes of your issues like anxiety, depression, or thyroid issues. It's a lengthy process and adults may not have all the information they need.
It's also possible that you won't be diagnosed with ADHD, even when your GP agrees to refer you. A psychiatrist is able to diagnose ADHD when they believe your ADHD symptoms are causing significant impairment. If they believe you do not meet the criteria, they'll inform you the reason.
In the UK, it is legal in the UK to get treatment through the NHS in England, Wales and Northern Ireland in the event that you are diagnosed with ADHD. You could be able get medication through an Individual funding request, but it depends on where you live. You may be referred by your doctor to prescribe the medication you want. NHS specialists tend to prefer Methylphenidate, Atomoxetine or Straterra first. They don't always plan for lengthy time periods of titration.
It is beneficial to join an adult support group with ADHD, both in person and on the internet. They can be extremely positive and reassuring and can be a great way to discuss your experiences with others who understand.
How can I receive treatment?
GPs may refer adults to specialists ADHD services for assessment and treatment. They are typically located in NHS hospitals and NHS community health teams, for example the Maudsley Hospital in London offers a national ADHD adult diagnostic service. However, many NHS health providers aren't able to accept these reports and patients are often blocked from accessing care. This is due to lengthy waiting times or rejection of referrals.
Support groups informed the consensus meeting that many ADHD sufferers seek out private assessments and diagnosis to overcome the NHS's inability to invest in this area. Private clinics can provide a quicker and more efficient, and generally understanding diagnosis. They can also be helpful in screening for comorbidities, like anxiety and depression which are very common in ADHD and also in helping with titration until the final dose of the medication. The cost can vary from PS500 to PS1,200. Sometimes the diagnosis and dosage are priced separately.
The treatment and diagnosis for ADHD can vary from person to person. The most common treatment is medication, and this may be in the form of methylphenidates (Ritalin, Concerta) or atomoxetine (Strateva). Sometimes, non-drug interventions are useful, such as training and education for parents and families of individuals with ADHD. Some people suffering from ADHD discover that a change in diet can help, as well as trying to develop a sleep-friendly routine. Some people have found that hypnotherapy and psychotherapy can alleviate their symptoms. However the evidence supporting these therapies is less extensive.
It is unacceptable that so many adults suffering from ADHD cannot get the treatment and care they need through the NHS. The UK government, the clinical and regulatory authorities need to act urgently to address this situation. Patients with ADHD must have access to treatment that is devoid of discrimination and consistent with their rights under the law. The long-term planning of financing, and joint commissioning of social, health care and judicial services are crucial to reduce this unmet need. The current situation is not sustainable and the effect on families, individuals and the entire society is devastating. It is time to invest in this area.
